Ventilation mask

ABSTRACT

Disclosed is a nasal ventilation mask having separate ports to monitor end-tidal CO 2  expulsion integrated into the mask in order to monitor end-tidal CO 2  expelled nasally or orally. Also disclosed is a CPR mask for nose-to-mouth and/or mouth-to-mouth resuscitation, having a body shaped to cover the nose and/or mouth of a victim, the mask including a CO 2  absorber for eliminating at least in part rescuer&#39;s exhaled CO 2  delivered to the victim.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/272,160, filed Sep. 21, 2016, which is a continuation of U.S. patentapplication Ser. No. 15/127,758, filed Sep. 20, 2016, which in turnclaims priority from PCT Patent Application Serial No.PCT/US2015/044341, filed Aug. 7, 2015, which claims priority from U.S.Provisional Application Ser. No. 62/039,759, filed Aug. 20, 2014, andfrom U.S. Provisional Application Ser. No. 62/078,677, filed Nov. 12,2014, and from U.S. Provisional Application Ser. No. 62/161,041, filedMay 13, 2015, the disclosure of each of which is incorporated herein byreference in its entirety.

BACKGROUND OF THE INVENTION

The present invention relates to improvements in anesthesia masks andventilation masks.

During surgery a patient usually is placed under anesthesia. The mostcommon delivery system consists of canisters containing anesthesia gasesand oxygen, a system of regulating the gas flow and the patient'sbreathing, and a device ensuring the potency of the patient's airway forbreathing, oxygenation and the delivery of the anesthetic gas mixture. Aventilation mask is used to provide oxygen to the patient either duringemergency and/or elective airway management, which includes but is notlimited to; before a patient is anesthetized for surgery, while thepatient is anesthetized, if the patient is sedated during the surgery orprocedure, while the patient is recovering from anesthesia, after thepatient has recovered from anesthesia, or during any event where apatient requires supplemental oxygen. However, one of the drawbacks ofmask ventilation is that it requires constant contact between theprovider's hands and the patient's face to hold the mask in place andkeep the patient in the sniffing position in order to ensure that oxygenand anesthetic gases do not leak out into the air and that the patient'sairway remains patent. If the provider does not maintain the patient inthe sniffing position, a dangerous complication known as upper airwayobstruction may occur. The reason the provider needs to performcontinuous mask holding and maneuvering is the human anatomy andphysiology. When muscles of the jaw, tongue and upper airway relax dueto sedatives and/or muscle relaxants given to the patient for sedationand/or anesthesia, the upper airway (mouth, pharynx, larynx) may becomepartially obstructed and possibly completely closed. Wherein, when thejaw of the patient drops and the tongue obstructs the airway resultingin snoring (partial obstruction) or apnea (complete inability for oxygento pass via the upper airway into the lungs). Another problem existswhen a provider fails to administer enough anesthesia or sedation or itbegins to wear off and the patient begins to move. This can cause thepatient's airway to obstruct as well since the patient's head and neckposition are no longer in the sniffing position. Patient movement duringsurgery can also be dangerous because it can cause the surgeon to make amistake, particularly in eye, ear, nose, neck, head, and throat surgery.

Furthermore, situations arise during surgery that require rapidintubation of a patient. Full face masks, i.e. masks covering both thenose and mouth of a patient are problematic in emergency situationssince a mask must be removed to uncover the mouth of a patient forintubation. However, removing the mask also removes oxygen support. Aswill be described below, the present invention in one aspect addressesthe aforesaid and other disadvantages of the prior art.

The present invention, in another aspect relates to cardiopulmonaryresuscitation (CPR) masks.

Cardiopulmonary resuscitation, commonly known as CPR is an emergencyprocedure performed in an effort to manually preserve intact brainfunction until further measures may be taken to restore spontaneousblood circulation and breathing in a person (hereinafter the “subject”or “victim”) who is in cardiac arrest. CPR also is indicated in thosewho are unresponsive with no breathing such as in the case of a drowningvictim or victim of electrical shock, or abnormal breathing, for exampleagonol respiration.

CPR involves chest compressions at least two inches deep and at a rateof at least 100 per minute in an effort to create artificial circulationby manually pumping blood through the heart and thus the body. Therescuer also may provide breaths by either exhaling directly into thesubject's mouth, or through a CPR mask into the subject's mouth and/ornose (collectively “mouth-to-mouth resuscitation”), or using a devicethat pushes air into the subject's lungs through the subject's mouthand/or nose. The process of externally providing ventilation is termed“artificial respiration”. Current recommendations place emphasis onhigh-quality chest compressions over artificial respiration; however,when coupled with high-quality chest compressions, artificialrespiration provides potentially the greatest benefit to the patient.

Conventional CPR masks are held in place by hand, by the CPR provider,or may be retained in position by straps that extend behind the head ofthe subject or victim. While CPR masks may assist in ventilation of asubject or victim who is not breathing, when a rescuer providesmouth-to-mouth and/or nose-to-mouth resuscitation, the air providedcontains a significant amount of CO₂ which is lethal. As will bediscussed below, the present invention in another aspect addresses theaforesaid and other disadvantages of the prior art.

SUMMARY OF THE INVENTION

The present invention in one aspect provides an improvedventilation/anesthesia mask that overcomes the aforesaid and otherproblems of the prior art. More particularly, there is provided a nasalventilation/anesthesia mask comprising one or more offset gas openingsto allow the provider to have a clear view of the mouth and airwayduring direct laryngoscopy and intubation, which consists of aventilation port to supply oxygen and other gases during anesthesia viaNon-Invasive Positive Pressure Ventilation (NIPPV) and which isconnected to an anesthesia circuit which can measure end-tidal CO₂ fromthe nose, an oral opening port under the nose for scavenging anesthesiagases and end-tidal CO₂ that are expelled orally from the patient; a gasscavenging/end-tidal CO₂ port connected to a channel inside the maskthat is isolated from the nasal cavity, and an oxygen port for supplyingpost op oxygen. Completing the mask are a plurality of tabs or eyelets,preferably three, or four, for strapping the mask to the patient's heador for tying the mask down to the operating table, e.g., in accordancewith the teachings of our PCT application PCT/US14/44934 and on PCTapplication PCT/US15/34277.

In one embodiment of the invention there is provided a nasal ventilationmask having an O₂ port for introducing oxygen into the mask, aventilation port and a gas monitoring attachment integral to or attachedto the ventilation port. In such embodiment, the gas monitoring portincludes a luer lock.

In another embodiment of the invention, there is provided a nasalventilation mask having an exterior opening under a nose region in themask, over the patient's lip region, that allow gases expelled orally tobe scavenged and ported to a scavenger device, said mask optionallyfurther including a Scavenger line for diverting a portion of theexpelled gas to be monitored for end-tidal CO₂, and, wherein a connectorpreferably is provided at point where the end-tidal CO₂ monitoring lineintercepts the Scavenger line, effectively diverting the gas flow,resulting in a positive pressure relative to the end-tidal CO₂ linewhereby to permit gasses to be sampled from the scavenger line.

In such embodiment, the mask may further comprise an anesthesiologistcontrolled 2-way, 3 port valve permitting an anesthesiologist to switchbetween separately monitoring nasal and oral expulsions of end-tidal CO₂or monitoring them simultaneously when the valve is open to both,wherein, when the Oral end-tidal CO₂ monitoring port is chosen, theend-tidal CO₂ monitoring line preferably also serves to scavenge otherventilation gasses during anesthesia.

The present invention also provides a nasal ventilation mask having tabsor eyelets for attaching the mask anteriorly with the mask anchor, orposteriorly with a traditional anesthesia mask strap, said mask furtheroptionally characterized by one or both of the following features:

(a) allowing only one combined anterior-posterior head strap to beattached, where the posterior head strap can attach to the mask alone,or can attach to the mask and then to a surface, which will preventmovement of the patient's head and/or neck; or

(b) securing the patient's head with a head strap to the supportsurface, where the patient's head will stay in a desired position andthe support surface will stay in the desired position when the providerchanges the head and/or neck angles.

In yet another embodiment of the invention there is provided a nasalmask characterized by one or more of the following features:

(a) wherein the mask is usable as an oxygen transport mask or as aVentilation mask providing O₂ and anesthesia gases and for monitoringend-tidal CO₂ simultaneously;

(b) having ports for monitoring end-tidal CO₂ via one or more ports,that can be used for CPAP pre-operatively, intra-operatively, andpost-operatively;

(c) having ports for monitoring end-tidal CO₂ via one or more ports,that can be connected to a resuscitator bag in such a way that thepatient's mouth and airway are not obstructed by the resuscitator bag toallow for direct laryngoscopy and intubation;

(d) wherein the mask is attachable anteriorly with a mask anchor, orposteriorly with a traditional anesthesia mask strap; and

(e) having an O₂ port for introducing oxygen into the mask, aventilation port and a gas monitoring attachment integral to or attachedto the ventilation port, wherein the gas monitoring port preferablyincludes a luer lock

The present invention also provides an anesthesia mask having a built inscavenger system for collecting anesthetic gases that leak out aroundthe mouth and/or nose.

In yet another embodiment, the present invention provides a chin strapfor application to the submental space, attached to a nasal mask, forapplying pressure to force a wearer's tongue against the soft palate andinduce an obstruction of the retro-glossal space, whereby to reduce orprevent leakage of gases out of the patient's mouth and allow thepatient to breath out of the nose, wherein the chin strap also has theability to release pressure, if needed, during exhalation to prevent anexpiratory obstruction.

In another aspect the present invention provides an improved CPR maskfor mouth-to-mouth and/or nose-to-mouth resuscitation and includes a CO₂absorber that eliminates re-breathing of rescuer or provider exhaled CO₂by the victim. More particularly, the present disclosure provides a CPRmask which includes a CO₂ filter or absorber built into the mask or maskinlet for absorbing CO₂ being exhaled by the rescuer or provider.

That is to say, there is provided a CPR mask for mouth-to-mouth and/ornose-to-mouth resuscitation, comprising a body shaped to cover the noseand/or mouth of a victim, said mask including a CO₂ absorber foreliminating at least in part rescuer exhaled CO₂ delivered to thevictim.

In one embodiment, the CO₂ absorber is coated on an inside surface ofthe mask.

In another embodiment, the mask includes a ventilation tube, wherein theCO₂ absorber is located in the ventilation tube.

In still another embodiment the mask includes one-way valve and/orstraps for holding the mask to the head of the victim.

In one embodiment the mask includes a compliant periphery to conform tothe face of a victim. In such embodiment, the periphery may include asoft, compliant air bladder, or resiliently deformable foam cushion.

In yet another embodiment, the mask includes a biological filterincorporated into the inside of the mask, or incorporated into theventilation tube.

In still yet another embodiment of the invention, there is provided aCPR mask as above described, further characterized by one or more of thefollowing features:

(a) including a one-way valve;

(b) including straps for holding the mask to the head of the victim; and

(c) wherein the mask further includes a compliant periphery to conformto the face of a wearer, wherein the periphery preferably includes asoft, compliant air bladder or a resiliently deformable foam cushion.

BRIEF DESCRIPTION OF THE DRAWINGS

Further features and advantages of the present invention will be seenfrom the following detailed description, taken in conjunction with theaccompany drawings, wherein

FIGS. 1a and 1b are front view and top views of a nasal ventilation maskin accordance with the first embodiment of the present invention;

FIG. 2 is an inside view of the FIG. 1a ventilation mask;

FIGS. 3a and 3b are plan views showing the ventilation mask inaccordance with the present invention on a patient's head;

FIGS. 4a and 4b are views similar to FIGS. 3a and 3b showing a chinstrap attached to the mask;

FIGS. 5a and 5b show an alternative configuration of the nasal mask withan end-tidal CO₂ monitor in accordance with the present invention;

FIG. 6 is a side elevational view of an alternative configuration ofnasal mask ventilation system in accordance with the present invention;

FIG. 7 is a plan view of an alternative embodiment of nasal ventilationmask with a CO₂ monitor in accordance with the present invention;

FIG. 8 is a plan view of yet another alternative configuration of nasalmask with a CO₂ monitor in accordance with the present invention;

FIG. 9 is a view, in partial cross-section of a CPR mask in accordancewith the first embodiment of the present invention; and

FIG. 10 is a side elevational view of a second embodiment of a CPR maskin accordance with the present invention.

DETAILED DESCRIPTION OF THE DRAWINGS

A nasal ventilation mask 10 in accordance with a first embodiment of thepresent invention is illustrated in FIGS. 1a and 1b . Optimally itcontains 4 gas openings, but can contain less or more than four as well.The first is the ventilation port 12 that supplies O₂ and other gasseseither during anesthesia or for NIPPV in critically ill patients andallows for any end-tidal CO₂ that is expelled nasally to be retrievedfrom the patient. The second is an Oral opening 14 under the nose butisolated from the nasal cavity created by the mask over the patient'snose. The purpose of opening 14 is for scavenging anesthesia gases andend-tidal CO₂ that are expelled orally from the patient. In addition toreducing or eliminating anesthetic gasses from entering the OperatingRoom and becoming a hazard, it allows for the end-tidal CO₂ expelledfrom the patient's lungs and escaping orally to be monitored. The thirdopening is the Gas Scavenging/end-tidal CO₂ port 16 that is connected tothe opening by a channel 18 inside the mask (see FIG. 2) that isisolated from the nasal cavity. The Gases, including any expelledend-tidal CO₂, leave the mask through port 16 and are guided by a tube20 to a gas scavenging filter and end-tidal CO₂ monitor 32 (see FIG. 3)that samples gas from the gas scavenging line. The fourth opening is anO₂ port 22 that is capped off during anesthesia, but may be connected toan O₂ source (not shown) either pre-operation, intra-operation, orpost-operation. When O₂ is supplied, the Ventilation tube is detachedfrom the ventilation port 12 so that end-tidal CO₂ and be expellednasally. A gas hood 24 located under the nose around the oral opening 14extends beyond the mask as shown. It is optionally included in order toextend the influence of the Oral Opening 14 in the mask in order tocontain a greater percentage of the expelled gases from the patient.

The mask also includes three eyelets or tabs 60, 62, 64, or four eyeletsor tabs 66 68, 70, 72 (FIG. 7) for attaching a chin strap or head strap,as described below, or for attaching straps to the operating table inaccordance with the teachings of our application PCT/US14/44934 or ourPCT application PCT/US15/34277.

An interior view of the nasal ventilation mask 10 of the presentinvention is illustrated in FIG. 2. The ventilation port 12 and O₂ port22, are connected to the nasal cavity 26. Orally expelled gases travelfrom the Oral opening 14 on the outside of the mask through Gas Channel18 and out the Gas Scavenger & end-tidal CO₂ monitoring port 16 on tothe Scavenger device and end-tidal CO₂ monitor. The Gas channel 18separates the Nasal cavity 26 created by the ventilation mask over thenose and the Oral regions of the patient.

When O₂ or O₂ and anesthesia gasses and are being supplied to thepatient, they travel to the nasal cavity 26 through a ventilationcircuit 28 attached to the ventilation port 12, and a cap shown inphantom at 30, seals the O₂ port. Post operation, the cap 30 can beremoved from the O₂ port 22 and an O₂ line attached to the port,supplying O₂ to the patient. The ventilation circuit 28 is removed fromthe ventilation port 12 and the nasal cavity 26 is open to theatmosphere where end-tidal CO₂ can be expelled nasally.

The gas circuit for both the Nasal Mask Ventilation/end-tidal CO₂monitor Oral Gas Scavenger/end-tidal CO₂ monitoring lines areillustrated in FIGS. 3a and 3b . FIG. 3a shows nasal gas flow from theNasal cavity 26 connected to the Ventilation Circuit 28 and to theend-tidal CO₂ monitoring equipment 32. FIG. 3b shows the orally expelledgasses entering the Oral opening and flowing through the Gas Scavengerline to a recovery device 34 and the associated line that is connectedto the scavenger line and flows to the end-tidal CO₂ monitoringequipment. Note that the opening to the scavenger line should bepositioned approximately 90° to the scavenger gas flow in order for thelocal pressure to be higher than it would be if the opening wereperpendicular to the gas flow. If it were perpendicular, a negativepressure would prevent the end-tidal CO₂ monitoring line from being ableto sample the flow due to the negative pressure gradient.

Referring also to FIGS. 4a and 4b , a chin strap 36 also can be appliedto the submental space, attached to the nasal mask 10, and apply apressure to force the tongue against the soft palate and induce anobstruction of the retro-glossal space, which will help prevent any leakof gases out of the patient's mouth and allow the patient to breath outof the nose. The chin strap 36 also has the ability to release pressure,if needed, during exhalation to prevent an expiratory obstruction andallow end-tidal CO₂ and other gases to be released out the mouth.

In an alternate configuration, the gas circuit for both the Nasal MaskVentilation and end-tidal CO₂ monitoring are illustrated in FIGS. 5a and5b . The figure shows a 2-Way, 3 Port valve 40 that connects the Nasalcircuit to the end-tidal CO₂ monitoring equipment. The anesthesiologistdecides which region, the nasal, oral region, or both simultaneously,should be monitored for end-tidal CO₂.

A side view of the alternate configuration for the nasal maskventilation and monitoring end-tidal CO₂ expulsion from the oral airwayis illustrated in FIG. 6. Note the 2-Way, 3 Port valve 40 has beenturned in the direction of the mouth for sampling end-tidal CO₂.

The nasal ventilation mask also allows only one combinedanterior-posterior head strap to be attached, where the posterior headstrap can attach to the mask alone, or can attach to the mask and thento a surface, which will prevent movement of the patient's head and/orneck. By securing the patient's head with the head strap to the supportsurface, the patient's head will stay in the desired position and thesupport surface will stay in the desired position when the providerchanges the head and/or neck angles.

FIG. 7 illustrates yet another embodiment of the invention, in which apatient is being provided oxygen via an O₂ line connected to the O₂ porton the ventilation mask. The exhaled gasses are exhausted to theatmosphere via the ventilation port 12 as illustrated in FIG. 7. If thepatient is unconscious due to anesthesia, there is a desire to assurethat the CO₂ is being exhaled. This can be accomplished by adding a“T-Shaped” gas monitoring attachment 50 that slides onto the maskventilation port 12. The main body of the attachment 50 which is tubularin shape allows exhaled gasses to be exhausted to the atmosphere. To theside of the attachment is a tubular opening 52, nominally at a 90° angleoff to the side. The end of this opening 52 can have a luer lock or anyother kind of securing connection. Exhaled gas from the main flow can besampled through this opening if a gas monitoring line 54 connected to agas monitor is attached to the gas monitoring line interface.

An alternative approach for accomplishing the same gas sampling featureis illustrated in FIG. 8. In this embodiment, the gas monitoring lineinterface is an integral element of the mask ventilation port 12. Inthis configuration, O₂ flows into the O₂ port via a supply line and theexhaust gases are passed to the atmosphere via the ventilation port 12.The side of the ventilation port 12 is a tubular opening 56, nominallyat 90° angle off to the side. The end of this opening can have a luerlock or any other kind of securing connection. Exhaled gas from the mainflow can be sampled through this opening if a gas monitoring lineconnected to a gas monitor is attached to the gas monitoring linesurface.

Referring to FIG. 9, there is shown a first embodiment of a CPR mask inaccordance with another aspect of our invention, designated 110, toaffect rescue breathing, mouth-to-mouth resuscitation or any other CPRprocedure requiring emergency breathing assistance. Mask 110 is shapedto cover the nose and/or mouth of a victim, and includes a soft andcompliant periphery 112 to conform to the face of a victim uponapplication of moderate force to obtain a tight-fitting mask seal.Typically the periphery 112 of the mask includes a soft, compliant airbladder 114 or resiliently deformable foam cushion or the like.

A ventilation tube 116 is attached to an integral inlet port 118protruding from the mask through which air may be supplied by therescuer by exhaling into the tube. Ventilation tube 116 or inlet port118 typically includes a one-way valve 120 that permits air to enter themask through tube 116. Ventilation tube 116 and its associated valve 120may be formed integrally with the port 118, or may be a replaceable,disposable element or package. (FIG. 10).

The inside surface 122 of mask 110 is coated in part by a CO₂ absorbingmaterial such as activated carbon or a zeolite. Also, certain mineralssuch as serpentinite advantageously may be employed. Typically, thesematerials are sorted to optimal size and encased in a filter material124 bound to the inside surface 122 of the mask 110. Alternatively, theinside surface 122 of the mask 110 may be coated with a CO₂ absorbingpolymer such as polyethylenimine containing fumed silica or the like asreported in Scientific American, Jan. 6, 2012, page 33.

Alternatively, as shown in FIG. 10, a CO₂ filter 126 containing CO₂absorbing material may be incorporated into ventilation tube 116.

In use, the rescuer places the CPR mask 110 over the nose and/or mouthof a victim to initiate emergency ventilation of the victim. The rescuerapplies moderate force to obtain a substantially air-tight seal againstthe victim's face, and ventilation is then supplied by the rescuer byexhaling into the ventilation tube 116. While the exhaust from therescuer contains CO₂, most of the CO₂ will be removed by the CO₂ filtermaterial.

Mask 110 may be formed in different sizes, for example, adult size,youth size and child size, to accommodate different size faces. Afeature and advantage of the CPR mask of the present invention is thatsignificantly reduces the amount of CO₂ administered to the victim.Also, the mask helps to protect both victim and rescuer in an emergencysituation by preventing transfer of disease.

Various changes may be made in the above invention without departingfrom the spirit and scope thereof. For example, a biological filter(shown in phantom at 130 in FIG. 10) also may be incorporated into themask or the ventilation tube 116. Additionally, the mask may includestraps 132 for strapping the mask to the victim's head, thus freeing therescuer from having to press the mask against the victim's face. Stillother changes are possible.

What is claimed is:
 1. A nasal ventilation mask having a body defining anasal cavity having an interior configured to cover a patient's nosewhile leaving a patient's mouth uncovered, the mask having an O2 port, aventilation port, and an end-tidal CO2 port, the O2 port fluidly coupledto the nasal cavity for introducing oxygen into the nasal cavity, theventilation port fluidly coupled to the nasal cavity for directing a gastoward or away from the nasal cavity, and the end-tidal CO2 port fluidlycoupled to an exterior opening under a nose region of the mask, adaptedto overlie a patient's lip region and isolated from the nasal cavity,wherein the end-tidal CO2 port is configured to couple with a monitoringline, and the ventilation port is configured to couple with aventilation line that is different than the monitoring line, and theexterior opening is adapted to scavenge gases expelled orally by awearer.
 2. The mask of claim 1, wherein the mask is adapted for use asan oxygen transport mask, or as a ventilation mask providing O2 andanesthesia gases.
 3. The mask of claim 1, wherein the mask is adaptedfor CPAP pre-operatively, intra-operatively, and/or post-operatively. 4.The mask of claim 1, wherein the mask is adapted for connection to aresuscitator bag such that a patient's mouth and airway are notobstructed by the resuscitator bag, to allow for direct laryngoscopy andintubation.
 5. The mask of claim 1, wherein the mask comprises a gaschannel inside the nasal cavity, wherein the gas channel fluidly couplesthe end-tidal CO2 port to the exterior opening and is configured toisolate orally expelled gases from a rest of the cavity.
 6. The mask ofclaim 1, wherein the mask comprises a gas monitoring attachment.
 7. Themask of claim 6, wherein the gas monitoring attachment is integral to orattached to the ventilation port.
 8. The mask of claim 1, furthercomprising an anesthesiologist controlled 2-way, 3 port valve permittingan anesthesiologist to switch between separately monitoring nasal andoral end-tidal CO2, or simultaneously monitoring nasal and oralend-tidal CO2, wherein when oral end-tidal CO2 monitoring is chosen,ventilation gases expelled orally by the patient are also monitored. 9.The mask of claim 1, wherein the mask comprises a scavenger lineconfigured to for diverting at least a portion of the scavenged gas toan end-tidal CO2 monitor.
 10. The mask of claim 9, wherein a connectoris provided where the monitoring line intercepts the scavenger line,diverting gas flow, resulting in a positive pressure relative to themonitoring line, to permit gases to be sampled from the scavenger line.11. A nasal ventilation mask comprising a body defining a nasal cavityhaving an interior configured to cover a patient's nose while leaving apatient's mouth uncovered, the mask having a first port fluidly coupledto the nasal cavity and configured for introducing oxygen into the nasalcavity, a second port fluidly coupled to the nasal cavity and configuredfor directing a gas toward or away from the nasal cavity, and a thirdport fluidly coupled to an exterior opening under a nose region of themask, wherein the exterior opening is isolated from the nasal cavity andis adapted to overlie a patient's lip region, and the third port isconfigured to couple with a monitoring line, the second port isconfigured to couple with a ventilation line that is different than themonitoring line, and the exterior opening is adapted to scavenge gasesexpelled orally by a wearer.
 12. The mask of claim 11, wherein the maskcomprises a gas channel inside the nasal cavity, wherein the gas channelfluidly couples the third port to the exterior opening.
 13. The mask ofclaim 11, wherein the mask comprises a gas monitoring attachment. 14.The mask of claim 13, wherein the gas monitoring attachment is integralto or attached to the second port.
 15. The mask of claim 11, furthercomprising an anesthesiologist controlled 2-way, 3 port valve permittingan anesthesiologist to switch between separately or simultaneouslymonitoring any of the first, second, and third ports.
 16. An anesthesiamask having a body defining a nasal cavity having an interior configuredto cover a patient's nose while leaving a patient's mouth uncovered, theanesthesia mask having a first port, a second port, and a third port,and a scavenger system, the first port fluidly coupled to the nasalcavity and configured for introducing oxygen into the nasal cavity, thesecond port fluidly coupled to the nasal cavity and configured fordirecting a gas toward or away from the nasal cavity, and the third portcoupled to an exterior opening under a nose region of the mask andadapted to overlie a patient's lip region, and the scavenger systemconfigured for collecting anesthetic gases that may leak out around amouth and nose of a patient, the scavenger system comprising the thirdport and a gas hood, the gas hood located under the nose region of theanesthesia mask and extending from an outer surface of the anesthesiamask around the exterior opening to enhance the collection of anestheticgases around the patient's mouth, wherein the third port is configuredto couple with a monitoring line, and the second port is configured tocouple with a ventilation line that is different than the monitoringline.
 17. The mask of claim 16, wherein the mask comprises a gas channelinside the nasal cavity, wherein the gas channel fluidly couples thethird port to the exterior opening.
 18. The mask of claim 16, whereinthe mask comprises a gas monitoring attachment.
 19. The mask of claim18, wherein the gas monitoring attachment is integral to or attached tothe second port.
 20. The mask of claim 16, further comprising ananesthesiologist controlled 2-way, 3 port valve permitting ananesthesiologist to switch between separately or simultaneouslymonitoring any of the first, second, and third ports.